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Individual

KELLEY LYNN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC-S, LCAC

Contact information

Practice address
809 S PATTON, PO BOX 1223, GREAT BEND, KS 67530
(620) 796-2206
(620) 796-2208
Mailing address
PO BOX 1223, GREAT BEND, KS 67530-1223
(620) 796-2206
(620) 796-2208

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
660
KS
101YP2500X
Professional Counselor
Primary
2362
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100098090A
KS
Enumeration date
03/23/2007
Last updated
04/02/2025
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